Healthcare Provider Details

I. General information

NPI: 1255922944
Provider Name (Legal Business Name): ABADA, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2021
Last Update Date: 02/23/2024
Certification Date: 02/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8840 CYPRESS WATERS BLVD STE 150
COPPELL TX
75019-4780
US

IV. Provider business mailing address

600 PINTAIL PL
FLOWER MOUND TX
75028-7121
US

V. Phone/Fax

Practice location:
  • Phone: 972-876-3214
  • Fax: 833-437-1270
Mailing address:
  • Phone: 940-453-4711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE MARCHESE
Title or Position: PRACTICE MANAGER
Credential:
Phone: 214-205-4995